230277 Evaluation of Training of Health Workers in Brief Motivational Interviewing in the Developing World: A South African Example

Wednesday, November 10, 2010

Alejandra Mijares, MPH , Behavioral Sciences, Emory University, Atlanta, GA
John E. Martin, PhD , Psychology, Fuller Theological Seminary, Pasadena, CA
Delia Lang, PhD MPH , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Graham Bresick, MD, MPH , Division of Family Medicine, Department of Public Health and Primary Health Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Background: The present study was developed to assess the ability of health workers in antiretroviral clinics in South Africa, to learn and apply Motivational Interviewing (MI) during HIV/AIDS patient care sessions. It was hypothesized that after completion of an 8 hour MI training workshop and one feedback/coaching session: (1) Health workers would employ more MI strategies in their interactions with patients compared to their standard of care; and (2) Health workers would reach MI beginning proficiency as measured by the Motivational Interviewing Treatment Integrity code (MITI).

Methods: Twenty four health workers were recruited from five rural public antiretroviral clinics. Audio-tape recordings were obtained of health workers during actual patient sessions. The study was conducted in three phases: (1) baseline data-collection; (2) MI training intervention of health workers; and (3) post- intervention data collection. Paired t-tests and one-sample t-tests were performed to test hypotheses.

Results: Results from this study showed no significant differences between first baseline scores and first feedback/coaching scores, and between mean baseline scores and first mean feedback/coaching scores. Overall participants scored significantly lower than MITI beginning proficiency thresholds. Qualitative analysis of MITI trends indicate that with three cycles of feedback and coaching health workers could reach beginning proficiency in MI.

Conclusion Further research in the training of health workers in MI, should contemplate 4-5 feedback/coaching cycles to ensure beginning proficiency. Given the desire of participants to be in the study, this study illustrates that the training of health workers in MI is a feasible endeavor.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Public health or related research
Social and behavioral sciences

Learning Objectives:
At the conclusion of the session, the participant (learner) in this session will be able to: Identify basic motivational counseling principles and methods Recognize barriers in training health workers in rural antiretroviral clinics of South Africa. Understand the primary improvements in counseling performance following training.

Keywords: International Public Health, Health Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversaw the development, implementation and analysis of this project; and I currently manage a five year HIV research project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.